乌拉地尔、艾司洛尔预防气管插管时心血管反应的研究

目的：比较乌拉地尔和艾司洛尔预防气管插管时循环副反应的效果。方法：50例病人随机分为对照（C）组14例、乌拉地尔（U）组19例和艾司洛尔（E）组17例。U组和E组于诱导前5min分别静注乌拉地尔0．3mg／kg和艾司洛尔0．5mg／kg，C组静注5mL生理盐水。分别记录诱导前、诱导后、插管即刻、插管后1、2、3、4、5、6min的SBP、DBP、HR的数值，并计算RPP。结果：C组于插管后发生明显的心血管反应（P＜0．01）。U组病人插管后BP无明显增高，与C组比较有显著差异（P＜0．01），HR变化与C组比较无显著差异，与基础值比较有显著差异（P＜0．01）。E组各项指标于插管后稳定，与C组比较有显著差异（P＜0．01）。结论：乌拉地尔能有效地减轻气管插管的升压反应，但不能防止心动过速的发生；艾司洛尔较乌拉地尔更能有效地抑制气管插管后的心率增快，同时亦能预防血压升高和降低心肌氧耗。

STUDY ON CARDIOVASCULAR EFFECTS OF URAPIDIL AND ESMOLOL IN THE PREVENTION OF TRACHEAL INTUBATION

Objective:To compare the preventive effects of urapidil and esmolol on cardiovascular reaction during tracheal intubation.Methods:Fifty adult patients were randomly divided into three groups:the control group(C group,n=14),the urapidil group(U group,n=19),the esmolol group(E group,n=17).Urapidil 0.3mg/kg in group U and esmolol 0.5mg/kg in group E were injected intravenously respectively 5min before induction of anesthesia.Hemodynamic was determined before induction of anesthesia,after induction of anesthesia,during intubation and 1,2,3,4,5,6min after intubation respectively.Results:The significant cardiovascular reaction were observed in group C during intubation(P<0.01).In group U,BP were not changed significantly after intubation and were significantly lower than that of group C(P<0.01),and HR was not changed significantly than that of group C.In group E,all of the above mentioned parameters were stable after intubation compared with group C(P<0.01).Conclusion:Urapidil is effective in attenuating pressure response to tracheal intubation but can not prevent tachycardia.Esmolol may have a better effect on tachycardia than urapidil and prevent hypertension and reduction of myocardial oxygen consumption.